Prevalence and determinants of dyslipidemia in 2338 Dutch childhood cancer survivors: a DCCS-LATER 2 study
Year: 2024
Type: article
Study design: Observational Study
Abstract: OBJECTIVE: Childhood cancer survivors (CCS) face an increased risk of early cardiovascular disease (CVD). In our nationwide CCS cohort, we assessed the prevalence and determinants of dyslipidemia, a well-established risk factor for accelerated atherosclerosis and CVD. METHODS: Prevalence of dyslipidemia was cross-sectionally assessed in 2338 adult CCS and compared to adults with no cancer history (Lifelines, n = 132 226). Dyslipidemia was defined by multiple classifications as well as lipid abnormalities to investigate the impact on prevalence and determinants. Logistic regression models, adjusted for age, sex, and BMI, were used to assess the cohort effect on presence of dyslipidemia. Determinants of dyslipidemia were identified through multivariable logistic regression. RESULTS: CCS (median age 34.7 year, median follow-up 27.1 year) had significantly increased odds of dyslipidemia compared to the reference cohort according to all classifications (NCEP-ATP-III, WHO, EGIR, CTCAEv.4.03). In survivors without lipid-lowering agents (n = 2007), lipid abnormalities were present in 20.6% (triglycerides > 1.7 mmol/L), 30.3% (HDL-c < 1.0/1.3 mmol/L (male/female)), 29.9% (total cholesterol > 5.2 mmol/L), 7.3% (LDL-c > 4.1 mmol/L), and 7.7% (apolipoprotein-B > 130 mg/dL). Compared to references without lipid-lowering agents (n = 126 631), survivors had increased odds of high triglycerides (aOR = 1.89, 95% CI = 1.68-2.13), low HDL-c (aOR = 2.73, 95% CI = 2.46-3.03), and high apolipoprotein-B (aOR = 1.84, 95% CI = 1.53-2.20). Sex, age, BMI, physical activity, abdominal/pelvic, cranial, and total body irradiation, alkylating agents, smoking, growth hormone deficiency, and diabetes mellitus were associated with (≥1 definition of) dyslipidemia in CCS. CONCLUSIONS: CCS is at increased risk of dyslipidemia, with various modifiable and non-modifiable determinants identified, underscoring the importance of survivor-specific risk assessment tools to control cardiovascular morbidity and mortality in this high-risk population.
Authors: Melissa Bolier, Vincent G Pluimakers, Demi T C de Winter, Marta Fiocco, Sjoerd A A van den Berg, Dorine Bresters, Eline van Dulmen-den Broeder, Margriet van der Heiden-van der Loo, Imo Höfer, Geert O Janssens, Leontien C M Kremer, Jacqueline J Loonen, Marloes Louwerens, Helena J van der Pal, Saskia M F Pluijm, Wim J E Tissing, Hanneke M van Santen, Andrica C H de Vries, Aart-Jan van der Lely, Marry M van den Heuvel-Eibrink, Sebastian J C M M Neggers
Institutions: Erasmus MC, Princess Máxima Center, Leiden University, Leiden University Medical Center, Emma Kinderziekenhuis, Amsterdam University Medical Centers, Cancer Center Amsterdam, Vrije Universiteit Amsterdam, University Medical Center Utrecht, Radboud University Nijmegen, Radboud University Medical Center, University Medical Center Groningen, University of Groningen, Wilhelmina Children's Hospital, Erasmus MC - Sophia Children’s Hospital
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,316
OpenAlex ID: W4404544422